IndividualActive
Jessica Bautista, NP
NPI 1184485492 · Gerontology Nurse Practitioner · Portland, OR
Provider details
- NPI number
- 1184485492
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- License
- 10020493 (OR)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
9155 Sw Barnes Rd Ste 238
Portland, OR 97225
Phone: (503) 215-9297
Approximate (ZIP-level) locationGet directions
Mailing address
9155 Sw Barnes Rd Ste 238
Portland, OR 97225-6629
Registry dates
- Enumerated
- 2024-01-23
- Last updated
- 2025-08-20
- Certified
- 2025-08-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.